Online Hearing TestHome•Online Hearing Test Email First Name * Last Name * Email Address Do you feel people around you mumble? * Yes No Sometimes Can you hear people but have trouble understanding what they are saying? * Yes No Sometimes Do you have difficulty hearing the TV? * Yes No Sometimes Do your family members/housemates feel like you keep the TV volume too loud? * Yes No Sometimes Do you find that you miss keywords in a conversation when in a noisy environment or area? * Yes No Sometimes Do you ask people to repeat themselves? * Yes No Sometimes Can you hear some people but have trouble understanding what they are saying? * Yes No Sometimes Do you have trouble hearing soft voices such as women and children? * Yes No Sometimes Do you avoid large groups or gatherings for fear of not being able to participate in the conversation? * Yes No Sometimes Is there a specific setting that you feel you would like to hear better in? * Yes No Sometimes If yes, what is it? Do people around you such as family members feel like you may have a hearing loss? * Yes No Sometimes Do you have trouble hearing over the telephone? * Yes No Sometimes Additional Comments / Questions
